Hardly @ Work

My husband is taking some graduate management courses online. A discussion question the other day focused on ways to reward employees for doing their job. Silly me. I thought that's what paychecks were for.

Obviously, one of the problems we're facing as a nation is that the entitlement mentality has taken over the workplace.

Consider the New Haven, Conn., firefighter case. Yes, the one in which the Supreme Court overturned Judge Sonia Sotomayor, who pushed for entitlements in denying promotions to firefighters who had studied hard to pass a qualifying exam for a shot at 15 openings for lieutenant and captain. More than 100 firefighters took the test, and many of them failed, including 27 African Americans. Fearing a discrimination lawsuit, the city threw out the test results. Denied promotions, 20 who had followed the city's promotion rules and passed the exam -- 19 whites and one Hispanic -- filed a reverse discrimination suit. Echoing Sotomayor's reasoning in her dissent, Justice Ruth Bader Ginsburg wrote that the firefighters who had passed the exam "had no vested right to promotion" (Hartford Courant).

Since entitlements aren't for people who work, I guess next time they won't study so hard.

Hilda Solis, the new Labor secretary, also is promoting entitlements in the workplace by pushing for labor unions on demand and an even higher minimum wage. Although the federal minimum wage is jumping to $7.25/hour in July, Solis is concerned that the federal wage is lower than that of several states. The inconvenient truth is that the cost of living varies greatly across this country. Believe me, $7.25/hour will go a whole lot further in Little Rock than it does in northern Virginia.

In an interview with the Washington Post, Solis trots out the tired argument that you can't raise a family on minimum wage. Inconvenient Truth No. 2: Minimum wage is a starting point. If someone who's been working full-time for more than a year is still making minimum wage, there's a problem. And much of that problem can be solved by a little personal initiative -- to ask for a promotion, find a different job or improve the job skills.

The irony is that President Obama, Sotomayor, Ginsburg and Solis didn't get where they are by entitlements. They worked hard to achieve their success. But now, they're basically telling the next generation there's no need to get an education, to work hard, to achieve. The government will take care of you.

And silly me. I work for a living.

Spinning the Healthcare Change

The spin is on big time when it comes to changing healthcare. (Note that I am not using the term reform, which suggests improvement. President Obama ran on a platform of change -- not reform. I'm convinced our healthcare system will change but not necessarily for the better.)

One of the president's healthcare buzz terms was comparative-effectiveness research (CER) -- also known as cost-effectiveness research in some circles. Because of legitimate concerns that CER could lead to a one-size-fits-all healthcare system, the government has come up with a new name for it. Now it's "patient-centered research," according to a news release put out today by HHS Secretary Kathleen Sebelius. The purpose of this research is to "help give patients and doctors more information so they can make the best decisions," the news release says.

No matter how you spin it, the gist is the same. We are spending $1.1 billion in "stimulus" money on CER to find out how to limit Medicare/Medicaid coverage without cutting entitlements. Of course, most of our money will never be spent on research. Much of it has to pay for the council that was set up to steer the research, the reports that various agencies are doing to discuss the need for the research, all the "listening sessions" in which said council will listen to public health officials describe the problems to be solved by the research, preparation for congressional hearings on the research, education (read "propaganda") programs to sell us on the results of the research, etc. Very little will be left to actually spend on the research.

The council today made a number of recommendations on how the HHS secretary should spend her $400 million of the $1.1 billion CER stimulus money. Topping the list? "It is critically important to be able to share the results of comparative effectiveness research with doctors and patients and make better investments in how information is disseminated," the news release says. In other words: spin, baby, spin. That's our tax dollars at work.

Joey's Take -- Trailblazer or Roadkill?

When it comes to dogs, there are basically five kinds of leaders:

-- The Lone Wolf. He starts out as leader of the pack but ends up on his own because no one wants to go in his direction.

-- The Pup. Rash and inexperienced, he's in a hurry to get anywhere else. He doesn't take the time to learn from the past and sniff out the dangers of the trail. Since he doesn't have a clear idea of where he wants to go, he tends to wander. In his haste, he loses his way -- or gets run over by the rest of the pack.

-- Old Faithful. This dog never wanders off the beaten path. He's always got his nose to the ground so he can lead the pack down the same trail everyone else has taken.

-- The Yapper. His nose is constantly in someone else's business. He's so busy barking and whining about what others have done, he leads the pack in circles.

-- The Trailblazer. This dog generally has had experience and has great instincts. But he still takes the time to smell the scents, test the water and plot out a reasonable course. While he doesn't needlessly lead the pack headlong into danger, he stands his ground when necessary. He understands that leadership isn't about being popular -- or having power. It's about vision, responsibility, integrity and accountability.

With the mess our country is in, we need to start seriously thinking about our future leaders -- at the local, state and national levels.

Me? I'm looking for trailblazers.

Acute Myopia

Chances are that if you need a cardiac stress test, bone scan, SPECT scan or any number of nuclear diagnostic imaging tests, you're going to be waiting for a long, long time. While you're waiting, you can thank all the enviros who ranted about the dangers of nuclear power. You also can thank Senate Majority Leader Harry Reid (D-Nev.) and Presidents Clinton and Obama.

The problem is an acute shortage of technetium-99m -- or Tc-99m. This radioactive isotope is used in 85 percent of all nuclear medicine diagnostic imaging tests and is generated from molybdenum-99 (Mo-99), which is produced at only a handful of aging nuclear reactors worldwide -- none of which is located in the U.S. Because of the short half life of Tc-99m, it cannot be stockpiled.

We, along with much of the world, get most of our Mo-99 from Canada's Chalk River reactor that is scheduled to be decommissioned in two years. The current global shortage is due to a leak discovered last month at this reactor, forcing it to shut down for repairs that could take up to eight months. This shortage is just a sample of what awaits us in a few years.

Back in the '80s and early '90s, there was a concerted push to develop nuclear facilities in the U.S. for medical purposes. But when Clinton was elected president, one of the few campaign promises he kept was to eliminate plans for any new reactors. The concern at the time was how to safely handle the spent fuel rods and other waste generated at such facilities. That concern gave rise to national myopia when it comes to all things nuclear.

The myopia has increased under the current administration. Although modern reactors produce much less radioactive waste than their predecessors, we have yet to develop a permanent repository for that waste. Yes, we have spent more than $14 billion to develop the Yucca Mountain Nuclear Waste Repository in Nevada, but we'll never see anything for that money. Reid and Obama have declared Yucca Mountain a dead issue and have cut the funding for the project.

Without a repository for the waste, there's little hope of getting any new reactors built, which means we will continue to be dependent on other nations for much of our nuclear medicine. And when there is limited supply, the price soars.

The myopia of the past has become more acute because of the current administration's focus on healthcare reform. The two conditions have created a new fix -- reduce the demand for the medical isotope by restricting coverage for nuclear diagnostic imaging tests. This would have the added benefit of lowering medical costs, the healthcare reformers reason. Afterall, if you don't diagnose a disease, you don't have to treat it. And if you don't treat it, you will have fewer people who need healthcare. Or Medicare. Or Social Security.

In other words, we have traded nuclear engineering for social engineering.

Problem? Or Solution?

Mention the word "feedlot" to most people, and they'll immediately think of a smelly nusiance. Animal rights groups will tell you a feedlot is cattle torture. And enviros would have you believe that feedlots are a major culprit in global warming.

But there are a few think-outside-the-box creative types who understand that feedlots can be part of the answer to our energy problems. In fact, a forward-thinking Vermont farmer teamed up with an engineer to create a manure digester that turns cattle waste into energy. From 1,000 head of cattle, he can produce enough energy to totally power 350 homes. This technology is now being used in several large dairy states.

This man, who ran unsuccessfully as a Republican for a state Senate seat, shows that what most people view as a problem may actually be a solution. It's just a matter of perspective. And that never-say die attitude that made the U.S. a great nation.

When it comes to the environment, we should not give in to knee-jerk reactions or a follow-the-crowd mentality that could threaten our food supply and do more harm than good in the long run. Instead, we should follow the example of this farmer and turn our problems into practical solutions.

Joey's Take -- Roadkill

Every morning when I'm riding in the redmobile to get Mom to work, I bark at all the bloated deer corpses along the highway. They literally litter the roadside along the Beltway.

Sure, there are barriers to keep them out. But, considering themselves "smarter than the average bear," the deer ignore the fences and cement walls -- even the scent of corpses rotting in the wind -- to get to the easy grazing alongside the road. Those barriers are for other animals -- not them.

Once on the road, they are blinded by the bright lights and confused by the chaos and rush of traffic. But they don't turn tail and head for the woods. Nope. They edge closer and closer to the speeding cars, lured by all that horsepower cruising by them.

Forgetting their natural instincts and all the animals depending on them back home, they sacrifice everything they are, becoming the latest roadkill -- and fodder for all the vultures feeding on the Beltway.

Hmm. Reminds me of some of the political animals lured by the bright lights of D.C.

Playing Politics

Remember that incident Democrats, including Sen. Obama, tried to blow up into “Attorney-gate” under President Bush? They didn’t like the fact that he replaced nine U.S. attorneys midstream, claiming it smacked of politics. Never mind that these attorneys served at the pleasure of the president and at least one of them had spent a number of years threatening to quit.

Now just five months into his term, President Obama seems to be playing politics with a government watchdog who blew the whistle on two of the president’s supporters who misspent AmeriCorp funds. For his trouble, Gerald Walpin, inspector general of the Corporation for National and Community Service and a Bush hold-over, was abruptly fired last week by Obama.

When the president’s action was questioned by senators, including a few in his own party, the character assassination began. Walpin’s, that is. The White House released a letter from a senior counsel to the president that justified the firing based, in part, on what it called Walpin’s “confused, disoriented” behavior at a board meeting a few weeks ago when he allegedly was unable to respond to questions, according to the New York Times.

(If that’s grounds for dismissal, the president has a lot of people to fire. Have you seen the video of the congressional hearing in which Rep. Alan Grayson, D-Fla., questions Elizabeth Coleman, the Federal Reserve inspector general? She comes across as somewhat confused and unable to respond to the questions she’s asked.)

A president has the right to appoint whom he wants to various positions -- and get rid of whom he wants. But unlike Obama, Bush didn't stoop to character assassination, even though it meant he put his own reputation out there to be hung.

Where's the Savings?

When Candidate Obama hit the campaign trail, he promised to reform the nation's healthcare system. One of his promises was to cut through the costs.

President Obama is trying to deliver on those campaign promises -- sort of. He is trying to bring change to our healthcare system. But if you've been following all the reports on his efforts, you know his proposals are adding to the bill -- not reducing it.

For starters, the president and the Democrat-controlled Congress devoted $1.1 billion for comparative-effectiveness research -- basically comparing one treatment against another to see which works best for the least amount of money for the most people. However, several Democratic leaders, including Sen. Max Baucus, are stipulating that this research cannot be used to cut healthcare costs. Hunh?

Meanwhile, the president is touting a $2 trillion savings in healthcare costs over 10 years -- based on a conversation he had with industry. He uses that savings to balance the $1 trillion he's planning on spending on healthcare coverage and other "reforms." Since that meeting, the healthcare industry has outlined some vague steps that might save some money but nowhere near $2 trillion.

Yesterday, the Congressional Budget Office (CBO) released a document acknowledging that many of the industry proposals will not affect government healthcare spending and the ones that do will fall far short of the president's promise. Responding to the CBO report, Sen. Chuck Grassley (R-Iowa) says in a statement, “As predicted, the $2 trillion savings pledge didn’t materialize from CBO’s perspective. The headlines generated by the White House event a month ago don’t get us much closer to affording health care reform today.”

Victims of the 24/7 News Cycle

The death of the city newspaper often is blamed on the economy. But what really killed it is the 24/7 news cycle created by CNN and the Internet. By time a newspaper is printed, its news is already history.

Another victim of the 24/7 news cycle is good, solid reporting. Since this cycle is driven by a constant supply of new information, the emphasis is on producing words -- not on investigating truth. As a result, sound bites have become the golden currency of the media. And words really do speak louder than action.

Think about it. A government official eloquently reads a speech written by a professional speech writer. But before a reporter has a chance to match the official's action with his words, the news cycle has moved on to the next sound bite. Most people, yielding to short attention spans and the desire for novelty, don't care that the official's speech doesn't align with his life. And if those few people who do care try to point out the contradictions, they're ignored, ridiculed or considered irrelevant dinosaurs.

Thus, someone like Al Gore, for instance, can become the guru of the green movement even though his carbon footprint is bigger than that of Paul Bunyan.

A Return to Honor

I was born and raised, for the most part, in central Illinois in a family still closely tied to its Southern roots. Drummed into us from birth was the Southern code of honor, which was bound to God, family and community -- in that order. An integral part of that honor was manners.

By manners, I don't mean merely knowing which fork to use first at a formal dinner or refraining from burping in public. For my parents and grandparents, manners were a daily extension of the Golden Rule: You respect others if you want them to respect you. Manners were the rules of society that helped us disagree without being disagreeable, as my father, the "country parson," is fond of saying. By exercising manners, we learned accountability -- to ourselves and to others.

Somewhere along the line, we have forgotten our manners. Young people refuse to offer their seats to the elderly. Children tear through stores, knocking into people with no apology -- and no parent scolding them. Students swear at their teachers. Service workers have no clue what "service" means.

What is even sadder is the demise of public discourse. Gone are the great orators who honored their word. Today's public forum is filled, instead, with noisy political hackers who joke about the statutory rape of Gov. Palin's daughter. Or who think it's OK to call Michelle Obama's ancestors gorillas -- so long as it's done in jest. Such lack of self-restraint demeans the person who says such things as well as the community that encourages it.

Today when there are so many serious problems facing our nation, we need people who can intelligently address the issues -- courteously, respectfully and maturely. And, given that Republicans are the minority party, we're going to have to work twice as hard to demonstrate that we have the ideas, and the temperament, necessary to lead our country away from the edge of the abyss.

Joey's Take -- Get a Life

I am proud that one of me is living in the White House. It's quite a rise for a breed that didn't make it to the U.S. until the 1970s and that was only recently recognized by the American Kennel Club.

But the other day, I was struck by the liability of having a Portuguese water dog as First Dog. Since most people don't know a lot about my breed, they may judge me based on what they hear about Bo. So when Bo offered the White House press corps a photo op a week or so ago, I was all eyes.

The photo op went like this: Bo's two handlers -- these were paid dog staff and not Michelle, the president or the girls -- had Bo out on the White House lawn. He was immediately surrounded by a gaggle of media (or is it a herd?), all squatting on the ground pointing cameras at him. Intrigued by the mic attached to a TV camera that was coming in close on him, Bo started playing tug-of-war -- a favorite Portie game -- with the mic sock. Trouble is, Bo lost. Yes, he's just a puppie, but give me a break. How hard is it to strip a mic sock from an inanimate camera?

After getting over the embarrassment reflected on my breed, I started thinking about this photo op thing. When Barney was First Dog, he always appeared with the president or Laura -- not hired handlers. Then I remembered -- this president promised to create thousands of jobs in D.C. Expanding the White House staff is one way to keep that promise.

My next thought was about all these "news" crews willing to step in dog poo to get a few shots of -- a dog. Yes, Bo is cute. All Porties are. But come on, he's a dog. On a lawn. Get a life!

I don't need to know what kind of dog food he eats. Who makes his collars. What his favorite treat is. If he has a favorite toy. How many times a day he relieves himself. Knowing that about Bo wouldn't make me any cooler than I already am. And it sure isn't going to change the way I live.

The Beginning of Hope

If you don't live in Virginia or New Jersey, you may not have caught the ray of hope that is beginning to dawn on the conservative horizon. Both states have off-year gubernatorial elections. And voters in both states so far are throwing their support to conservatives.

In Virginia, the glimmer paved the way for state Sen. Creigh Deeds, a conservative Democrat, to leave two liberal opponents stumbling in the dark as he raced past them in the primary this week -- despite being outspent, outgunned, out-endorsed and outnamed. Deeds captured 50 percent of the vote while Terry McAuliffe, a longtime Democratic Party operative, got 26 percent and the early favorite Brian Moran pulled in nearly 24 percent.

You may be familiar with McAuliffe. He's the one who engineered the Clinton coffees at the White House and the "renting out" of the Lincoln bedroom. McAuliffe, who had chaired Hillary's presidential campaign, came to the Virginia race late. In fact, he reportedly wanted to run for governor in Florida until he found out he had to live there seven years first. Despite his late entrance, he raised millions more than his opponents -- much of it from Hollywood -- and had several in-person endorsements from President Clinton.

Moran, who ran to the left of McAuliffe, comes from a prominent political family and has served in the state assembly. He also got the endorsement of the Kennedy clan. He was seen as the golden candidate until McAuliffe's candidacy bumped him off course.

But in the end, Virginia Democrats set their hopes on the conservative -- the one candidate who would not agree with President Obama on many of his policies. They told the Clintons, the Kennedys and even Hollywood, "No thanks." They proved Virginia is not as purple as the liberals would like you to believe.

Meanwhile in New Jersey, Republican challenger Chris Christie is coming on strong against incumbent Jon Corzine with taxes, particularly property taxes, and the economy playing as the biggest issues. Some pundits see President Obama as Corzine's only hope to retain his seat. But will the president risk his cache by campaigning for an incumbent who could lose?

Hope is dawning. And we're not even through the first six months of the Democratic reign.

Professor-in-Chief

Whether he's dealing with healthcare reform, nominating a Supreme Court justice, trying to forge peace in the Middle East or attempting to dig out of the economic mess he helped create as a U.S. senator, President Obama sticks to his professor's manual in how he handles the crisis at hand.

Five months into his presidency, Obama has exhibited a signature way of approaching every issue. First, the Speech -- more commonly known as a lecture in classroom parlance. In the Speech, he lays out some general guidelines or objectives and then pulls at the heartstrings with poignant anecdotes.

Next, the Assignment. Usually this is directed at Congress. But Obama has been known to make assignments to industry, agencies, associations and even Israel. On the heels of assigning homework, the president sets an arbitrary due date. And then like any good professor, he leaves the students to complete the project on their own.

While this method may work in the classroom, it is disastrous in government. Remember the "stimulus" package? Rushing to meet the president's due date, Democrats pushed through a thousand pages of spending proposals that no one -- including Professor President -- had a chance to review or evaluate. The Democrats are doing the same thing with Judge Sonia Sotomayor's nomination to the Supreme Court. For them, it is more important to meet Obama's deadline than it is to do a full-blown, meaningful review.

Meanwhile, the president gave them another assignment today: Come up with legislation to set a cap on executive pay at all publically traded companies. It will be interesting to see if any of the congressional Democrats question the teacher on this one.

Or perhaps by now the brighter students have figured out that this type of tutorial government leads to one result: The president/professor takes all the credit and the students in Congress get all the failing grades.

Other Cost-Savings Measures

I'm sure all of you can think of at least a handful of ways to lower our national healthcare bill. By themselves, each measure might not amount to much, but added together and multiplied across the country, they could total trillions of dollars in savings.

Here are a few of my ideas for healthcare providers, including hospitals:

--Require all healthcare providers to wear surgical gloves and masks when treating patients -- even in the doctor's office. Obviously, these would need to be changed often. Yes, there are costs associated with gloves and masks, but we could save by cutting the spread of contagious diseases and pathogens;
--Design waiting rooms and waiting times to reduce or eliminate the spread of illnesses;
--Require providers to regularly disinfect all areas and to routinely clean their air filtering systems;
--Require imaging techs to disinfect MRIs, mammography equipment, etc., after each use. To maximize the use of this expensive equipment, many facilities do not take the time to disinfect it, creating one of the major sources of healthcare-acquired infections (HAIs);
--Prohibit providers from billing for "never" events -- infections or injuries caused by their negligence. Medicare, Medicaid and many private insurers are refusing to pay for these; individuals should not have to pay for such mistakes either. If they have to pay for their own mistakes, maybe providers won't make so many;
--Allow hospital patients to use their regular medications from home rather than forcing them to pay the inflated-hospital price. For that matter, limit hospital drug prices to what area pharmacies charge;
--Allow hospital patients to use their own gowns, toothbrushes, disposable cups, etc., rather than having to pay inflated prices for the ones the hospital provides;
--Require providers to give patients the total cost of a procedure upfront along with the cost of alternatives. Then require them to honor that price quote;
--Require providers to submit itemized bills in a timely manner. Currently, some hospitals wait months and even years to bill so patients cannot challenge the items on the bill;
--Reform patent laws so pharmaceutical and medical device companies have an incentive to create innovative treatments without having to spend millions in court to protect their patents;
--Encourage competition once patents expire, but discourage generic companies from filing on new patents. Under the current system, generic companies often file years before a patent expires, hoping to get a healthy settlement from the brand company in exchange for delaying the launch of their copycat product. The resulting litigation, which often goes through several appeals, increases the costs of both the brand and the generic drugs; and
--Eliminate frivolous malpractice and injury suits; limit legitimate awards to a reasonable amount.

Feel free to add your ideas.

At the Doctor's Office -- Take 2

When the president and Congress are talking trillions of dollars for universal insurance coverage and comparative-effectiveness research -- all the big-dollar items of healthcare reform -- they tend to ignore the small practical steps that really could add up to make a huge dent in our national healthcare dollar.

Take the doctor's office, for instance. If doctors and other healthcare providers followed the lead of veterinarians in offering evening and weekend hours and took other steps to prevent lengthy office waits, we could see some real savings. For example, let's say Sally, an expectant mother, makes $15/hour (the median average wage for women in 2004, according to the U.S. Census Bureau). Over the course of her pregnancy, she will make at least 10 prenatal visits to the doctor. While her HMO will cover most of the cost, she will have to miss an average of three hours of work for each doctor's visit (including the commute), so she will miss a total of 30 hours of work because the doctor's office won't work around her schedule. If she doesn't get sick leave, she will lose $450 in pay. And even if she is covered, her office will lose 30 hours' worth of productivity.

According to the Centers for Disease Control and Prevention, 4,265,555 babies were born in the U.S. last year. For the sake of our example, let's just say that 3 million of the women giving birth to those babies worked and made an average of $15/hr. That would mean that in one year, the nation would lose $1.350 billion in productivity for this prenatal care. Over 10 years, that would total $13.5 billion. If you add to this the cost of time off work for all employees to go to the doctor or take their families to the doctor, the amount would be staggering.

Now, no one is suggesting that people shouldn't go to the doctor. But when people can't afford to take off from work for routine doctor visits, they end up going to the emergency room or waiting until their condition gets critical, both of which addseven more to the national healthcare bill. All of these problems could be addressed if we simply change the hours doctors, physical therapists, etc., practice -- or at least cut the amount of time people waste while waiting in the doctor's office.

But since this is a solution that could save billions of dollars while costing us nothing, it probably won't find its way into any national agenda for healthcare reform any time soon.

Joey's Take -- At the Doctor's

Call me crazy, but I like going to the vet's. I enjoy being the center of all that attention.

Even though I'm not covered by their health insurance, Mom and Dad make sure I get all my preventive care. It's always been affordable. The veterinarians are upfront about how much each shot or treatment will cost. And they've never prescribed unnecessary tests.

What amazes me is that we've never had to wait months to get an appointment for me. And Mom and Dad have never had to take off from work to get me to the vet's. All the vets we've gone to offer evening and weekend hours to accommodate working parents.

Except for the one time that I had an emergency visit on a Sunday, I've never had to wait more than a few minutes to get in to see the vet. And on the emergency visit, Mom walked me around outside while we waited so I wouldn't give the other dogs my cooties and I wouldn't get theirs.

Another thing I've noticed is that the results of my lab work generally are back within minutes. The longest they've ever taken is a day or two. And then the vet's office always called Mom and Dad to let them know that everything was OK.

If people doctors operated the way animal doctors do, healthcare costs could be cut drastically. For instance, just consider what their waiting rooms cost in terms of lost productivity and wasted time. Those rooms also are germ incubators. If you're not sick before you go to the doctor, give it a few days. Think about it. How often have you seen anyone truly disinfect the waiting room?

And when's the last time a doctor discussed treatment costs with you -- that is, before you complained about the bill? The last time Mom went to a doctor, he wanted to send her to a different specialist for every ache and pain she mentioned. He figured she had insurance, so it would be no dollar out of her wallet. Had she followed his advice, she would have been out of work for weeks just making the rounds and her insurance company would have shelled out thousands of dollars so all these specialists could tell her, "Hey, you're not so young anymore. Your body is going to ache occasionally."

When it comes to healthcare, people are a lot like Pavlov's dog. They've become too conditioned to the way things are. Healthcare reform shouldn't be about coverage; it should be about the way medicine is practiced in this country. It should be about patients becoming impatient with the status quo.

People doctors could learn a lot from the vet's office.

Healthcare Reform -- In the Workplace

In what is becoming his trademark style, President Obama sent a letter Wednesday to two Democrat congressmen, informing them that he expects them to have healthcare reform legislation passed by October. And in keeping with how he handled the stimulus, he's leaving the details up to Congress. He does signal that his idea of healthcare reform is basically public insurance.

Worrying about universal health insurance before seriously addressing healthcare itself is like treating a patient before diagnosing the problem. If we rethink how we handle healthcare and cut costs instead of merely slowing the growth (see yesterday's post below), insurance reform will naturally follow.

To truly cut healthcare costs, we must put everything on the table -- sick leave, doctor's office hours, hospital practices, treatment costs, malpractice lawsuits, drug patents, even the training of healthcare providers.

Let's start with the workplace, which is generally overlooked in healthcare discussions. Through sick leave policies -- or lack thereof -- the workplace can be a breeding ground for contagious illnesses and a huge obstacle to preventive care. Think about the problems with common sick leave policies:

--No or limited sick leave. Employees come to work sick, making others sick and reducing productivity. They also may not take the time for preventive appointments and may forgo necessary treatment that is only available during the workday. When they do seek help, their condition is pretty bad -- and costs a lot more to treat.

--Sick leave restricted to the employee only. Workers may not take children, spouses or elderly parents to necessary medical appointments -- until an emergency crops up. Again, the costs skyrocket.

--Family leave restricted to extended periods of time and only after all other leave is used. If workers could take family leave for a week or so without jeopardizing vacation time or their own sick leave, they would be free to care for family members while they're in the hospital or recuperating at home. This could cut down on in-home care and speed recovery time for their loved ones.

Changes in sick leave could be written into labor laws. And employers should be encouraged to promote telecommuting when their workers may be contagious but not too sick to work.

Sanitation is another obvious issue in the workplace. How many employers change their air filters regularly or clean the HVAC system? How many warn sensitive workers of pending pesticide spraying? How many workers do not properly wash their hands? These are simple things, but they all add up.

Feel free to contribute your ideas for changes that can be made in the workplace that would help with our healthcare crisis.

Next, we'll tackle the doctor's office.

Healthcare at a Crossroads – The Problem

The growing cost of healthcare was a national problem back in 1992 when Hillary Clinton failed to come up with a workable solution. It’s an even bigger problem today, costing us 18 percent of the national GDP – a figure that’s expected to nearly double over the next 30 years, according to a report released this week by the president’s Council of Economic Advisers. That means more and more of our paycheck – and a greater share of our tax dollar – will go for healthcare.

President Obama made healthcare reform a centerpiece of his campaign. And he’s told Congress it has to get it done this year or else. Although the president is spotlighting any vague promise of future savings as proof that his campaign speeches were more than rhetoric, a lot of Beltway insiders are admitting that the likelihood we’ll see any true reform is getting slimmer and slimmer.

The president can’t blame this one on the Republicans not playing nicely with the Democrats. The truth is that the Democrats aren’t playing nicely with each other. Some congressional Democrats are holding out for all or nothing – meaning they will settle for nothing but a universal, socialized coverage plan. Others insist on a more moderate approach.

Meanwhile, the president and his economic advisers are touting as real progress a broad promise extracted at a closed “summit” last month from a coalition of healthcare providers and pharmaceutical and medical device industry groups. After the afternoon summit, the president proudly announced, without giving any details, that the coalition had promised to slow the growth of healthcare costs by 1.5 percentage points a year over the next decade for a total savings of $2 trillion.

If that savings were to occur, the typical family of four would have $2,600 more in its pocket in 2020, according to the council’s report.

But since that summit, the members of the coalition have had a chance to crunch some numbers. They released a joint letter this week listing some general steps they could take to slow the growth of healthcare costs. (Note that we aren’t talking about actually cutting costs.) And in that letter, they say they might be able to save as little as half of the $2 trillion Obama is counting on.

Yes, we need healthcare reform. But if we want true reform, we’re going to have to come up with the solution ourselves – and then sell it to Congress and the various stakeholders.

I’ll start the ball rolling tomorrow night with some ideas that could realistically – and almost painlessly – change healthcare as we know it.

Lessons From History

I had a graduate history professor who insisted on teaching an undergraduate American history class every semester. "I want them to understand that the world didn't begin when they woke up this morning," he said of the freshmen and sophomores who enrolled in his class.

That's as true of all of us as it is of college freshmen. And the more we know and understand of our nation's history, the more we should expect from our leaders.

The cast of characters who have taken the stage on both the state and national levels throughout our history ranges from the rogue to the truly inspirational. Unfortunately, we hear more about the rogues than the heroes today.

Perhaps we need to consider what made our effective leaders legends in their own time:

--They were not born leaders. Rather, they were ordinary men and women who were willing to step up when no one else would.

--They didn't need polls to tell them what course to take, but they valued the counsel of knowledgeable, experienced advisers. And they knew the power -- and solace -- of prayer.

--They stood on principle, but they were able to admit when they were wrong.

--They didn't make promises they knew they couldn't keep. Their word meant something, and they were not going to cheapen it just to be PC or gain a few votes.

--They understood it was not about them -- it was about getting the job done.

--They didn't waste time comparing themselves to historic leaders. They had work to do.

--They realized leadership was more than making eloquent speeches or trading political barbs. For them, action did speak louder than words.

--They knew they had to set the example and inspire others to follow them. It was not a matter of "do as I say and not as I do."

--At the end of the day, they took all the blame but shared the credit.

--They recognized when it was time to move aside and let someone else take the reins. They understood that they were not the one and only.

--And, finally, they didn't worry about their place in history. That was for future generations to decide. It was enough that they had served.

Stick to the Real Issues

Even though Democrats have controlled Congress for nearly three years and the mortgage crisis can be traced back to policies started under the Clinton administration, 62 percent of Americans blame the current economic mess on Republicans, according to Rasmussen Reports.

The reason? We have allowed the Democrats to define the issues, shape the message and control the dialogue. If we want to reclaim any congressional seats next year, or even take a stab at the presidency in 2012, we must do a better job of telling our side of the story.

We are not going to do it by complaining about the president taking his wife to a Broadway play in New York. Every president is entitled to time off -- and away -- from the Beltway. And, yes, wherever they go, whatever they do, we have to pay for the security detail. It goes with the office.

On the other hand, we should be taking aim at a radio-phone-email campaign the Democratic Congressional Campaign Committee has launched against six House Republicans for their votes against President Obama's $787 billion stimulus package. This campaign, which started today, targets Rep. Brian Bilbray of California's 50th congressional district; Rep. Charlie Dent, Pennsylvania's 15th congressional district; Rep. Peter King, New York's 3rd congressional district; Rep. Thad McCotter, Michigan's 11th congressional district; Rep. Tom Rooney, Florida's 16th congressional district, and Alaska's Rep. Don Young. (Hey, haven't the Dems done enough damage to Alaska?)

The campaign is based on half-truths. For instance, the phone script being used in Michigan says, "Congressman McCotter even voted against the economic recovery plan, which is at work now to create or save over 109,000 Michigan jobs."

Yes, it is true that McCotter voted against the stimulus bill, which was passed in early February. But it is not true that the stimulus is doing anything for Michigan -- even though it was supposed to create jobs immediately. According to Michigan labor statistics, the state lost 38,000 jobs in April alone. If I lived in Michigan, I'd be asking the Democrats for my money back!

These are the facts we need to get out there -- along with real-world solutions. Only then will we be able to get our nation back on track.